Kelli Haut, is a medicare enrolled "Nurse Practitioner - Family" in Tripoli, Iowa. Her current practice location is
602 7th Ave Sw, Tripoli, Iowa. You can reach out to her office (for appointments etc.) via phone at
(319) 882-8534.
Kelli Haut is licensed to practice in Iowa (license number A165655) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1548905748.
Provider's Profile
| Full Name | Kelli Haut |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 602 7th Ave Sw, Tripoli, Iowa |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1548905748
- Provider Enumeration Date: 05/02/2022
- Last Update Date: 08/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 7012390610
- Enrollment ID: I20220815001842
Medical Identifiers
Medical identifiers for Kelli Haut such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1548905748 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | A165655 (Iowa) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelli Haut allows following entities to bill medicare on her behalf.
| Entity Name | Covenant Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548288160
PECOS PAC ID: 0244148732
Enrollment ID: O20031111000534 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelli Haut is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kelli Haut,
602 7th Ave Sw,
Tripoli, IA 50676-9700
Ph: (319) 882-8534 | Kelli Haut,
602 7th Ave Sw,
Tripoli, IA 50676-9700
Ph: (319) 882-8534 |
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